ABSTRACT
PURPOSE: Kaposi's sarcoma (KS) is a multifocal angioproliferative disease. In Peru, the implementation of the highly active antiretroviral treatment (HAART) program was in 2005, the model for treating patients with HIV-positive KS shifted to a potential cure. In this study, we aim to compare clinicopathological characteristics and prognostic factors associated with outcomes in patients with HIV-positive KS. METHODS: We developed a retrospective cohort study that includes patients with HIV/AIDS and KS seen in the Instituto Nacional de Enfermedades Neoplasicas between 1987 and 2017. Patients were divided into two groups according to the implementation of HAART in our country: the non-HAART group and those treated with HAART after 2005. Multivariate analysis for overall survival (OS) was performed with the Cox proportional hazard regression model. RESULTS: There was a greater visceral compromise and more extensive oral cavity involvement in the non-HAART group (60% 31.7%, P < .01). Regarding the immune status, there was a significant difference from the CD4 count at 1-year follow-up (73 v 335, P = .01). The CD4/CD8 rate were significant different before QT (0.23 v 0.13, P = .01) and at 1-year follow-up (0.12 v 0.32, P = .03.). The estimated 5-year OS rate was significantly lower (P = .0001) for the non-HAART group (41.7%; 95% CI, 25.9 to 56.9) compared with the HAART group (79.3%; 95% CI, 66.8 to 87.5). In the multivariate model for OS, full-HAART regimen and previous diagnosis of HIV/AIDS (P < .01) were significantly associated with longer survival. CONCLUSION: Clinical and demographic characteristics of our patients are compatible with the literature, but we report a higher rate of gastrointestinal involvement. Furthermore, our findings provide evidence for the importance of HAART and its ability to reduce KS-related mortality.
Subject(s)
Acquired Immunodeficiency Syndrome , Sarcoma, Kaposi , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/drug therapy , Anti-Retroviral Agents/therapeutic use , Antiretroviral Therapy, Highly Active , Humans , Peru/epidemiology , Retrospective Studies , Sarcoma, Kaposi/complications , Sarcoma, Kaposi/drug therapyABSTRACT
INTRODUCTION: Studies show a high prevalence of physical inactivity and sedentary behavior among university students. However, the relationship between physical activity and sedentary behavior in medical students is unknown. OBJECTIVES: To determine the prevalence of physical activity, sedentary behavior, and related factors among medical students at a public university. METHODS: We conducted an analytical cross-sectional study that included students from the first to the sixth year of medical school. We used the International Physical Activity Questionnaire (IPAQ). We analyzed study variables using Poisson regression, estimating crude and adjusted prevalence ratios. RESULTS: The final sample consisted of 513 students, of which 35% of women and 30.1% of all pre-clinical students had a low level of physical activity. Male sex and 20 to 24 age group were associated with a lower prevalence of low level of physical activity. Sedentary behavior was 60.9% among students under 20 years old and 55.5% among pre-clinical students. A lower prevalence of sedentary behavior was found in students over 25 years old, clinical students, and those with high levels of physical activity. CONCLUSION: Most medical students presented a moderate level of physical activity. We found a higher presence of low-level physical activity among females and pre-clinical students. We found that sedentary behavior was higher than reported in similar populations. The relationship between physical activity and lower sedentary behavior was significant only for students with a high-level physical activity.
INTRODUCCIÓN: Se ha reportado elevados porcentajes de inactividad física y sedentarismo en estudiantes universitarios. Sin embargo, el nivel de actividad física y su relación con el sedentarismo en estudiantes de medicina no es concluyente. OBJETIVOS: Determinar los niveles de actividad física y conducta sedentaria, así como factores relacionados a estas, en estudiantes de medicina humana de una universidad pública. MÉTODOS: Realizamos un estudio transversal analítico que incluyó a estudiantes de primer a sexto año académico de la carrera de medicina. Empleamos el cuestionario internacional de actividad física (IPAQ). Realizamos un análisis entre las variables de estudio mediante regresión de Poisson, que estimó razones de prevalencia crudas y ajustadas. RESULTADOS: La muestra fue de 513 estudiantes. Un 35% de mujeres y 30,1% de estudiantes de preclínica presentaron un nivel bajo de actividad física. El sexo masculino y el grupo de 20 a 24 años estuvieron asociados a una menor prevalencia de nivel bajo de actividad física. La conducta sedentaria fue 60,9% en el grupo menor de 20 años, y 55,5% entre estudiantes de preclínica. Los tres grupos en que se asoció una menor prevalencia de conducta sedentaria fueron el mayor a 25 años, los estudiantes de clínica, y los con nivel de actividad física alto. CONCLUSIONES: Los estudiantes de medicina presentaron principalmente un nivel moderado de actividad física. Hallamos una mayor presencia de actividad física baja entre estudiantes de sexo femenino y de preclínica. Encontramos un nivel de conducta sedentaria por encima de lo reportado en poblaciones similares. La relación entre nivel de actividad física y menor conducta sedentaria fue significativa solo para la categoría actividad física alta.
